Acute cardiac care最新文献_第10页

Mechanical versus manual chest compression CPR under ground ambulance transport conditions. 地面救护车运输条件下的机械与手动胸部按压心肺复苏术。

Acute cardiac care Pub Date : 2013-03-01 DOI: 10.3109/17482941.2012.735675

Julia Fox, René Fiechter, Peter Gerstl, Alfons Url, Heinz Wagner, Thomas F Lüscher, Urs Eriksson, Christophe A Wyss

{"title":"Mechanical versus manual chest compression CPR under ground ambulance transport conditions.","authors":"Julia Fox, René Fiechter, Peter Gerstl, Alfons Url, Heinz Wagner, Thomas F Lüscher, Urs Eriksson, Christophe A Wyss","doi":"10.3109/17482941.2012.735675","DOIUrl":"https://doi.org/10.3109/17482941.2012.735675","url":null,"abstract":"Background: Novel mechanical chest compression devices offer the possibility to transport cardiac arrest patients with ongoing CPR and might shorten significantly the time delay to post-resuscitation care.Methods: We simulated an eight-minute cardiac resuscitation situation during ambulance transport using CPR training manikins. We compared teams consisting of two experienced resuscitators with the performance of a mechanical chest compression device (LUCAS).Results: CPR-performance by two experienced resuscitators demonstrated ambivalent results. Whereas mean compression rate was within the recommended range (103/min, 95% CI: 93-113/min), mean compression depth was closely below the actually recommended compression depth of >5 cm (49.7 mm, 95% CI: 46.1-53.3mm). Nevertheless, only a mean of two thirds (67%) of all compressions were classified as manually correct (defined as sternal compression depth >5 cm). In contrast, the LUCAS device showed a constant and reliable CPR performance (99.96% correctly applied chest compressions correctly applied within the device programmed parameters, P = 0.0162) with almost no variance between the different sequences.Conclusion: The LUCAS CPR device represents a reliable alternative to manual CPR in a moving ambulance vehicle during emergency evacuation. Furthermore, it needs less human resources and is safer for the EMS personnel.","PeriodicalId":87385,"journal":{"name":"Acute cardiac care","volume":"15 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2013-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/17482941.2012.735675","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31343086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 64

Atrial septostomy in cardiogenic shock related to H1N1 infection. 心源性休克与H1N1感染相关的房间隔造口术。

Acute cardiac care Pub Date : 2013-03-01 DOI: 10.3109/17482941.2012.760740

Ziad Dahdouh, Vincent Roule, Thérèse Lognone, Rémi Sabatier, Massimo Massetti, Gilles Grollier

引用次数: 3

Grape clusters and tongue shaped vegetation on defibrillator lead. 在除颤器引线上的葡萄簇和舌形植被。

Acute cardiac care Pub Date : 2013-03-01 DOI: 10.3109/17482941.2012.735676

Punnaiah C Marella, Shishir Murarka, Shantipriya Siripurapu, Faran Bashir

引用次数: 1

Cardiac magnetic resonance detection of left ventricular thrombus in acute myocardial infarction. 急性心肌梗死左室血栓的心脏磁共振检测。

Acute cardiac care Pub Date : 2013-03-01 DOI: 10.3109/17482941.2012.741248

Chiara Lanzillo, Mauro Di Roma, Alessandro Sciahbasi, Monia Minati, Luciano Maresca, Gianluca Pendenza, Enrico Romagnoli, Francesco Summaria, Roberto Patrizi, Marco Di Luozzo, Paolo Preziosi, Ernesto Lioy, Francesco Romeo

{"title":"Cardiac magnetic resonance detection of left ventricular thrombus in acute myocardial infarction.","authors":"Chiara Lanzillo, Mauro Di Roma, Alessandro Sciahbasi, Monia Minati, Luciano Maresca, Gianluca Pendenza, Enrico Romagnoli, Francesco Summaria, Roberto Patrizi, Marco Di Luozzo, Paolo Preziosi, Ernesto Lioy, Francesco Romeo","doi":"10.3109/17482941.2012.741248","DOIUrl":"https://doi.org/10.3109/17482941.2012.741248","url":null,"abstract":"Introduction: Left ventricular thrombosis (LVT) is a possible complication of acute myocardial infarction. Aim of our study was to evaluate incidence and clinical characteristics of patients with LVT after ST elevation myocardial infarction (STEMI) using contrast- enhanced magnetic resonance (CMR).Methods and results: In a prospective cohort of 36 consecutive patients with STEMI acutely reperfused with primary percutaneous coronary intervention, CMR was performed within one week. LVT was found in 7 patients (19%), and was located in left ventricle apex or adherent to antero-septum. Compared to the rest of population patients with LVT have lower ejection fraction (38 ± 7% versus 51 ± 6%, P = 0.009), larger left ventricle end systolic volume (95.8 ± 19 ml versus 68.9 ± 19 ml, P = 0.02), higher time to reperfusion (9.3 ± 7.2 versus 5 ± 3.6, P = 0.03) and left anterior descending artery was constantly involved (100% versus 41 %, P = 0.06). In 5 cases the LVT was also detected by echocardiography, however, in 2 cases it was missed.Conclusions: The incidence of LVT after STEMI is not negligible and was accurately detected by CMR. Localization of myocardial infarction, time to reperfusion, ejection fraction and left ventricle end systolic volume are the most important predictors of left ventricle thrombus formation.","PeriodicalId":87385,"journal":{"name":"Acute cardiac care","volume":"15 1","pages":"11-6"},"PeriodicalIF":0.0,"publicationDate":"2013-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/17482941.2012.741248","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31343089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 16

The heart and potassium: a banana republic. 心脏和钾:香蕉共和国。

Acute cardiac care Pub Date : 2013-03-01 DOI: 10.3109/17482941.2012.741250

Ehsan Khan, Christine Spiers, Maria Khan

引用次数: 8

Gender- and race-based utilization and outcomes of pulmonary artery catheterization in the setting of full-time intensivist staffing. 基于性别和种族的肺动脉导管的使用和结果在全职重症监护人员的设置。

Acute cardiac care Pub Date : 2012-12-01 DOI: 10.3109/17482941.2012.741245

Micaela Iantorno, Julio A Panza, Nakela L Cook, Samantha Jacobs, Mary Beth Ritchey, Kathryn O'Callaghan, Daniel Caños, Howard A Cooper

{"title":"Gender- and race-based utilization and outcomes of pulmonary artery catheterization in the setting of full-time intensivist staffing.","authors":"Micaela Iantorno, Julio A Panza, Nakela L Cook, Samantha Jacobs, Mary Beth Ritchey, Kathryn O'Callaghan, Daniel Caños, Howard A Cooper","doi":"10.3109/17482941.2012.741245","DOIUrl":"https://doi.org/10.3109/17482941.2012.741245","url":null,"abstract":"Background: Little is known regarding gender- or race-based differences in critical care. We investigated whether gender or race was associated with pulmonary artery catheter (PAC) utilization or with in-hospital death among patients with a PAC. A particular focus was patients with cardiogenic shock (CS), in whom guidelines recommend PAC use.Methods: This was a retrospective cohort analysis from the coronary care unit of a large tertiary-care hospital staffed with full-time cardiac intensivists.Results: We analyzed 8845 consecutive adult patients, of whom 42.1% were women and 40.8% were black. PAC use rates were 11.3% in women and 11.5% in men (P = 0.79), and 11.3% in blacks and 11.5% in whites (P = 0.76). In CS patients, PAC use rates in women and men were 50.3% and 49.1% (P = 0.85) and in blacks and whites were 43.7% and 53.3% (P = 0.05). There was no independent association between gender or race and PAC use overall or in those with CS. Neither gender nor race was a predictor of in-hospital death in patients undergoing PAC.Conclusions: PAC use and in-hospital death were determined not by gender or race but by disease severity. Full-time intensivist staffing and the presence of definitive guidelines may reduce gender- and race-based treatment disparities.","PeriodicalId":87385,"journal":{"name":"Acute cardiac care","volume":"14 4","pages":"125-30"},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/17482941.2012.741245","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31102537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 5

Prevalence, kinetic changes and possible reasons of elevated cardiac troponin T in patients with AV nodal re-entrant tachycardia. 房室结型再入性心动过速患者肌钙蛋白T升高的患病率、动力学变化及可能的原因。

Acute cardiac care Pub Date : 2012-12-01 DOI: 10.3109/17482941.2012.741246

M Schueler, M Vafaie, R Becker, M Biener, D Thomas, M Mueller, E Giannitsis, Hugo A Katus

{"title":"Prevalence, kinetic changes and possible reasons of elevated cardiac troponin T in patients with AV nodal re-entrant tachycardia.","authors":"M Schueler, M Vafaie, R Becker, M Biener, D Thomas, M Mueller, E Giannitsis, Hugo A Katus","doi":"10.3109/17482941.2012.741246","DOIUrl":"https://doi.org/10.3109/17482941.2012.741246","url":null,"abstract":"Background: Elevated cardiac troponin (cTn) has been reported to occur with AVNRT. Little is known about prevalence, kinetic changes, and possible reasons of increased cTn.Methods: We evaluated 139 consecutive patients presenting with AVNRT to the emergency department between 2006 and 2010. Cardiac troponin T (cTnT) was measured serially at baseline, after three and six hours. Patients were evaluated for the presence of structural heart disease or CAD. Troponin was defined as elevated if a value exceeded the lower limit of detection (10 ng/l) using the fourth generation cTnT, or if the value > 99 th percentile (14 ng/l) using the new highly sensitive cTn assay.Results: A cTnT > LLD (n = 29) or > 99 th percentile (n = 16) was found in 45 patients (32.4%) within the initial six hours after hospitalization. All patients were symptomatic with palpitations, chest discomfort or dyspnea. A complete cardiac evaluation was carried out, including coronary angiography in 32 patients demonstrating an underlying structural heart disease or CAD in 18 cases (56%). Significant CAD was detected in 16 cases. 8 cases required PCI during hospitalization. Elevated cTnT was seen in patients with and without structural heart disease.Conclusions: AVNRT is a possible reason for elevated cTnT, even in the absence of relevant structural heart disease or CAD.","PeriodicalId":87385,"journal":{"name":"Acute cardiac care","volume":"14 4","pages":"131-7"},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/17482941.2012.741246","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31102538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 14

Atrial trans-septal thrombus in massive pulmonary embolism salvaged by prolonged extracorporeal life support after thrombo-embolectomy. A bridge to right-sided cardiovascular adaptation. 大块肺栓塞后经延长体外生命支持抢救的房间隔血栓。通往右侧心血管适应的桥梁。

Acute cardiac care Pub Date : 2012-12-01 DOI: 10.3109/17482941.2012.741247

Thijs S R Delnoij, Ryan E Accord, Patrick W Weerwind, Dirk W Donker

{"title":"Atrial trans-septal thrombus in massive pulmonary embolism salvaged by prolonged extracorporeal life support after thrombo-embolectomy. A bridge to right-sided cardiovascular adaptation.","authors":"Thijs S R Delnoij, Ryan E Accord, Patrick W Weerwind, Dirk W Donker","doi":"10.3109/17482941.2012.741247","DOIUrl":"https://doi.org/10.3109/17482941.2012.741247","url":null,"abstract":"Massive pulmonary embolism poses a therapeutic challenge, especially when thrombolytics are controversial. We describe the complicated course of an exceptional case of massive pulmonary embolism exhibiting paradoxic embolization with a thrombus lodged in the foramen ovale. Thrombolysis was considered contraindicated and surgical intervention was performed. Postoperatively, persistent pulmonary hypertension and impending right ventricular (RV) failure necessitated the initiation of extracorporeal life support (ELS), accompanied by therapeutic heparinization, inhaled nitric oxide, levosimendan and sildenafil. On day 8, the patient was successfully weaned from ELS with excellent neurological recovery and virtual normalization of RV pressures and dimensions. (Contra-) indications for thrombolysis and surgical embolectomy are reviewed. The intriguing role of ELS in conjunction with therapeutic heparinization and pharmacological unloading of the right-sided vasculature and the RV is discussed.","PeriodicalId":87385,"journal":{"name":"Acute cardiac care","volume":"14 4","pages":"138-40"},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/17482941.2012.741247","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31102539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 23

A contemporary re-evaluation of culprit lesion severity in patients presenting with STEMI. 当代STEMI患者罪魁祸首病变严重程度的重新评估。

Acute cardiac care Pub Date : 2012-12-01 DOI: 10.3109/17482941.2012.712140

Liam M McCormick, Stephen P Hoole, Adam J Brown, David P Dutka, Nick E J West

{"title":"A contemporary re-evaluation of culprit lesion severity in patients presenting with STEMI.","authors":"Liam M McCormick, Stephen P Hoole, Adam J Brown, David P Dutka, Nick E J West","doi":"10.3109/17482941.2012.712140","DOIUrl":"https://doi.org/10.3109/17482941.2012.712140","url":null,"abstract":"Background: Historical data report fatal myocardial infarction occurring when mildly-stenotic coronary plaques rupture; however, recent data suggest haemodynamically-significant coronary stenoses with fractional flow reserve (FFR) ≤ 0.8 and vessels with high plaque burden and minimum luminal area (MLA) < 4 mm(2) by intravascular ultrasound (IVUS) may be prognostically important. Therefore, we sought to re-evaluate culprit stenosis severity in patients presenting with ST-segment elevation myocardial infarction (STEMI).Methods: Patients undergoing primary percutaneous coronary intervention (PPCI) for STEMI with adjunctive thrombectomy between October 2008 and February 2010 (n = 336/572; 59%) underwent quantitative coronary angiography (QCA) after thrombus aspiration to determine vessel reference area (RA), MLA and percentage area stenosis (AS). To validate findings, QCA and FFR were measured in 50 patients with stable angina and an angiographically-intermediate lesion.Results: STEMI patients had anatomically-severe underlying culprit disease similar to that of the stable cohort (AS: 91.6 ± 9.5% versus 90.1 ± 8.1%; P = 0.11). Additionally, anatomically-severe lesions defined by QCA were more likely to be functionally-significant by FFR and vice-versa (P = 0.02 and 0.002 respectively).Conclusion: These contemporary data suggest that STEMI culprit lesions, defined by luminal stenosis after thrombus aspiration, are angiographically significant, with similar stenosis severity to stable, ischaemia-inducing lesions.","PeriodicalId":87385,"journal":{"name":"Acute cardiac care","volume":"14 4","pages":"111-6"},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/17482941.2012.712140","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31103152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 8

Comparison of Impella and intra-aortic balloon pump in high-risk percutaneous coronary intervention: vascular complications and incidence of bleeding. Impella与主动脉内球囊泵在高危经皮冠状动脉介入治疗中的比较:血管并发症及出血发生率。

Acute cardiac care Pub Date : 2012-12-01 DOI: 10.3109/17482941.2012.741244

Konstantinos Dean Boudoulas, Andrew Pederzolli, Uksha Saini, Richard J Gumina, Ernest L Mazzaferri, Michael Davis, Charles A Bush, Quinn Capers, Raymond Magorien, Vincent J Pompili

{"title":"Comparison of Impella and intra-aortic balloon pump in high-risk percutaneous coronary intervention: vascular complications and incidence of bleeding.","authors":"Konstantinos Dean Boudoulas, Andrew Pederzolli, Uksha Saini, Richard J Gumina, Ernest L Mazzaferri, Michael Davis, Charles A Bush, Quinn Capers, Raymond Magorien, Vincent J Pompili","doi":"10.3109/17482941.2012.741244","DOIUrl":"https://doi.org/10.3109/17482941.2012.741244","url":null,"abstract":"Objective: Compare vascular complications and incidence of bleeding of Impella 2.5 and intra-aortic balloon pump (IABP) in high-risk percutaneous coronary interventions (PCI).Background: Large arterial sheath size for device insertion is associated with vascular and/or bleeding complications; gastrointestinal bleeding may also occur with anti-coagulation use.Methods: Patients with an acute coronary syndrome receiving Impella 2.5 or IABP during high-risk PCI were studied (13 Impella; 62 IABP). Vascular complications and incidence of bleeding were compared.Results: Post-procedure hematocrit was similar between groups. Blood transfusion occurred in 38.4% and 32.2% of patients in the Impella and IABP groups, respectively (P = NS); 65.3%, 30.7% and 3.8% of bleeding were due to vascular access site/procedure related, gastrointestinal and genitourinary, respectively. There was no statistical significant difference in vascular complications between the Impella and IABP groups (15.3% and 6.4% of patients, respectively); mesenteric ischemia (n = 1) and aortic rupture (n = 1) were only in the IABP group. In-hospital and one-year mortality were not statistically significant between groups.Conclusion: Impella can be used as safely as IABP during high-risk PCI with similar vascular and bleeding complications. Importantly, approximately one third of bleeding was from the gastrointestinal system warranting careful prophylactic measures and monitoring.","PeriodicalId":87385,"journal":{"name":"Acute cardiac care","volume":"14 4","pages":"120-4"},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/17482941.2012.741244","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31102536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 23